healthcare

In the news: Doctors in Maharashtra attacked by patients' kin, South Asia pledges to end TB and more

A wrap of the week's health headlines.

Three instances of doctors being beaten up by relatives of patients who died during treatment were reported last week in Maharashtra.

On March 12, a resident doctor from Dhule Civil Hospital was assaulted by the relatives of an accident victim. The doctor reportedly suggested that the patient, who had suffered serious head injuries, be taken to a tertiary care hospital where a neurosurgeon could attend to him. This provoked a mob of about 20 people to beat him till he was unconscious.

The mob vandalised the hospital and attacked Dr Rohan Mhamunkar with rods and chairs, reported the Indian Express. Mhamunkar, 35, suffered serious to his eye and chest and became unconscious after the attack, as can be seen in the CCTV footage of the incident below. He is undergoing treatment in a Mumbai hospital.

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On Thursday, a doctor and nurse were allegedly manhandled by the relatives of a patient who died of H1N1 influenza or swine flu in Nashik. The 40-year-old patient was reportedly brought to the hospital in a serious condition. When nurse Charusheela Ingle informed his relatives of his death, they allegedly assaulted her and the doctor, Rahul Patil.

On Saturday evening, a resident doctor of Lokmanya Tilak Municipal General Hospital in Mumbai was allegedly assaulted by relatives of a 60-year old woman who died during treatment. The woman was suffering from chronic kidney disease, the doctors said.

On Wednesday, the state unit of the The Indian Medical Association held a rally at Azad Maidan in Mumbai to protest against frequent attacks on doctors and hospital staff, in light of the assault in Dhule.

In an opinion piece published in the Mumbai Mirror in 2015, Dr Sanjay Nagral, publisher of the Indian Journal of Medical Ethics, said the problem of violence against doctors moves beyond providing security. “Violence against health care workers is a complex problem with origins in a deficient health care mechanism, inadequate communication, rising costs, increased expectations and instigation by community leaders,” he said.

Online portal to regulate sale of antibiotics

The Union Health Ministry has proposed the creation of an online platform to regulate the sale of medicines in India. This will also include the sale of drugs online.

The portal will be developed and maintained by an autonomous body under the Ministry of Health and Family Welfare. “The objective of such regulation would be to ensure availability of right drugs that meet the standards of quality to every person, in need of medicines, curbing anti-microbial resistance and also regulating supply of medicines through online/internet to persons or other entities in outside India,” a government circular said.

Antimicrobial resistance is the ability of microbes to become immune to the effects of drugs that are supposed to kill them over time. One of the reasons for this is the overuse of such medicines and to counter this, efforts are being made is to promote the rational use of antimicrobials. This includes regulating over the counter sale of antibiotics, which drug regulators have failed to do in India.

As per the proposal, all manufacturers, stockists, distributors and pharmacies will have to register on the portal and those who are unregistered will not be licensed to sell medicines. All medicines will be bar-coded so that each sale can be tracked. The chemist will also have to enter the details of doctor who prescribed the medicine, whose registration number under the Medical Council of India will be recorded. The government has sought comments from the public till April 15 before they finalise the proposal.

Southeast Asia pledges to work towards ending TB

On Wednesday, health ministers from Southeast Asian countries signed a Call for Action to end TB. The countries, including India, which collectively have half the tuberculosis patients in the world, pledged to scale up efforts to reduce TB mortality by 90% and incidence by 80% by 2030.

Union Health Minister JP Nadda said India has pledged to end the disease by 2025, earlier than the global deadline. In 2015, TB caused nearly 8 lakh deaths in the Southeast Asian region and an estimated 40.74 lakh new cases were reported. India alone had 20.8 lakh new cases and an estimated 478,000 deaths.

Apart from India, the countries with a large burden of TB include Indonesia, Myanmar, Thailand and Bangladesh.

The World Health Organisation said in a release that the annual decline in the incidence of TB is a low 1.5% to 2% and needs to be scaled up to at least 10%-15% to meet targets.

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What hospitals can do to drive entrepreneurship and enhance patient experience

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Most of these tech enabled solutions have emerged as hospitals look for better ways to enhance patient experience – one of the top criteria in evaluating hospital performance. Patient experience accounts for 25% of a hospital’s Value-Based Purchasing (VBP) score as per the US government’s Centres for Medicare and Mediaid Services (CMS) programme. As a Mckinsey report says, hospitals need to break down a patient’s journey into various aspects, clinical and non-clinical, and seek ways of improving every touch point in the journey. As hospitals also need to focus on delivering quality healthcare, they are increasingly collaborating with entrepreneurs who offer such patient centric solutions or encouraging innovative intrapreneurship within the organization.

At the Hospital Leadership Summit hosted by Abbott, some of the speakers from diverse industry backgrounds brought up the role of entrepreneurship in order to deliver on patient experience.

Getting the best from collaborations

Speakers such as Dr Naresh Trehan, Chairman and Managing Director - Medanta Hospitals, and Meena Ganesh, CEO and MD - Portea Medical, who spoke at the panel discussion on “Are we fit for the world of new consumers?”, highlighted the importance of collaborating with entrepreneurs to fill the gaps in the patient experience eco system. As Dr Trehan says, “As healthcare service providers we are too steeped in our own work. So even though we may realize there are gaps in customer experience delivery, we don’t want to get distracted from our core job, which is healthcare delivery. We would rather leave the job of filling those gaps to an outsider who can do it well.”

Meena Ganesh shares a similar view when she says that entrepreneurs offer an outsider’s fresh perspective on the existing gaps in healthcare. They are therefore better equipped to offer disruptive technology solutions that put the customer right at the center. Her own venture, Portea Medical, was born out of a need in the hitherto unaddressed area of patient experience – quality home care.

There are enough examples of hospitals that have gained significantly by partnering with or investing in such ventures. For example, the Children’s Medical Centre in Dallas actively invests in tech startups to offer better care to its patients. One such startup produces sensors smaller than a grain of sand, that can be embedded in pills to alert caregivers if a medication has been taken or not. Another app delivers care givers at customers’ door step for check-ups. Providence St Joseph’s Health, that has medical centres across the U.S., has invested in a range of startups that address different patient needs – from patient feedback and wearable monitoring devices to remote video interpretation and surgical blood loss monitoring. UNC Hospital in North Carolina uses a change management platform developed by a startup in order to improve patient experience at its Emergency and Dermatology departments. The platform essentially comes with a friendly and non-intrusive way to gather patient feedback.

When intrapreneurship can lead to patient centric innovation

Hospitals can also encourage a culture of intrapreneurship within the organization. According to Meena Ganesh, this would mean building a ‘listening organization’ because as she says, listening and being open to new ideas leads to innovation. Santosh Desai, MD& CEO - Future Brands Ltd, who was also part of the panel discussion, feels that most innovations are a result of looking at “large cultural shifts, outside the frame of narrow business”. So hospitals will need to encourage enterprising professionals in the organization to observe behavior trends as part of the ideation process. Also, as Dr Ram Narain, Executive Director, Kokilaben Dhirubhai Ambani Hospital, points out, they will need to tell the employees who have the potential to drive innovative initiatives, “Do not fail, but if you fail, we still back you.” Innovative companies such as Google actively follow this practice, allowing employees to pick projects they are passionate about and work on them to deliver fresh solutions.

Realizing the need to encourage new ideas among employees to enhance patient experience, many healthcare enterprises are instituting innovative strategies. Henry Ford System, for example, began a system of rewarding great employee ideas. One internal contest was around clinical applications for wearable technology. The incentive was particularly attractive – a cash prize of $ 10,000 to the winners. Not surprisingly, the employees came up with some very innovative ideas that included: a system to record mobility of acute care patients through wearable trackers, health reminder system for elderly patients and mobile game interface with activity trackers to encourage children towards exercising. The employees admitted later that the exercise was so interesting that they would have participated in it even without a cash prize incentive.

Another example is Penn Medicine in Philadelphia which launched an ‘innovation tournament’ across the organization as part of its efforts to improve patient care. Participants worked with professors from Wharton Business School to prepare for the ideas challenge. More than 1,750 ideas were submitted by 1,400 participants, out of which 10 were selected. The focus was on getting ideas around the front end and some of the submitted ideas included:

  • Check-out management: Exclusive waiting rooms with TV, Internet and other facilities for patients waiting to be discharged so as to reduce space congestion and make their waiting time more comfortable.
  • Space for emotional privacy: An exclusive and friendly space for individuals and families to mourn the loss of dear ones in private.
  • Online patient organizer: A web based app that helps first time patients prepare better for their appointment by providing check lists for documents, medicines, etc to be carried and giving information regarding the hospital navigation, the consulting doctor etc.
  • Help for non-English speakers: Iconography cards to help non-English speaking patients express themselves and seek help in case of emergencies or other situations.

As Arlen Meyers, MD, President and CEO of the Society of Physician Entrepreneurs, says in a report, although many good ideas come from the front line, physicians must also be encouraged to think innovatively about patient experience. An academic study also builds a strong case to encourage intrapreneurship among nurses. Given they comprise a large part of the front-line staff for healthcare delivery, nurses should also be given the freedom to create and design innovative systems for improving patient experience.

According to a Harvard Business Review article quoted in a university study, employees who have the potential to be intrapreneurs, show some marked characteristics. These include a sense of ownership, perseverance, emotional intelligence and the ability to look at the big picture along with the desire, and ideas, to improve it. But trust and support of the management is essential to bringing out and taking the ideas forward.

Creating an environment conducive to innovation is the first step to bringing about innovation-driven outcomes. These were just some of the insights on healthcare management gleaned from the Hospital Leadership Summit hosted by Abbott. In over 150 countries, Abbott, which is among the top 100 global innovator companies, is working with hospitals and healthcare professionals to improve the quality of health services.

To read more content on best practices for hospital leaders, visit Abbott’s Bringing Health to Life portal here.

This article was produced on behalf of Abbott by the Scroll.in marketing team and not by the Scroll.in editorial staff.